Variations of wet-bulb globe temperature across high school athletics in South Carolina.

The purpose was to describe wet bulb globe temperature (WBGT) throughout a high school fall athletic season (August to November) after a state-wide mandate requiring schools to use a WBGT-guided activity modification table with categories (AMTC). A cross-sectional research design utilized 30 South Carolina high schools. The independent variables were region (upstate, midlands, and coastal), sport (football, tennis, cross-country), month, start times (7-10 am, 10 am-3 pm, 3-6 pm, and 6-9 pm), and event type (practice, competition). Dependent variables were event frequency, average WBGT, and AMTC. Practice WBGT was 78.7 ± 8.2 °F (range: 34.7 to 99.0 °F). A significant difference for WBGT across month (F, 904.7 = 385.07, P < 0.001) existed, with early September hotter than all other months (84.8 °F ± 3.8, P < 0.001). Every month had practices in each AMTC, until early November. Most events (64.6%, n = 1986) did not change AMTC; however, 9.1% (n = 281) changed to a hotter category. The 10 am-3 pm start time was significantly hotter than all other time frames (83.0 °F ± 7.2, P < 0.05). Tennis experienced hotter practices (79.9 °F ± 6.9) than football (78.4 °F ± 8.5; P < 0.001) and cross country (78.2 °F ± 8.8, P < 0.001). Schools in the Midlands experienced hotter practices (80.1 °F ± 7.8) than upstate (P < 0.001) and coastal schools (P = 0.005). Competition WBGT was significantly cooler than practices (72.3 ± 10.5 °F, t = 12.04, P < 0.001) and differed across sports (F, 20.78 = 18.39, P < .001). Both cross-country (P = 0.003) and tennis (P < 0.001) were hotter than football. Schools should continuously monitor WBGT throughout practices and until November to optimize AMTC use. Risk mitigation strategies are needed for sports other than football to decrease the risk of exertional heat illnesses.